Bellevue doctor launches psychedelics into the mainstream

Dr. Stephen Ross, senior director of the Division of Substance Abuse at Bellevue Hospital and associate professor of psychiatry at the NYU School of Medicine, began assembling a team to investigate the therapeutic benefits of psychedelics a decade ago. Since then, the drugs, which were widely researched in the 1950s and 1960s, have undergone a renaissance in the scientific community. Clinical trials are underway that could lead to Food and Drug Administration approval of psilocybin—the active ingredient in magic mushrooms—and ketamine, or "special K," for depression, and MDMA, the active ingredient in ecstasy, for post-traumatic stress disorder.

Ross has slowly gained institutional support and generated interest in the field from academic institutions across the country. He is even working on a trial with Janssen Pharmaceuticals, part of Johnson & Johnson.

But the gold standard for scientific research—funding from the National Institutes of Health—is still out of reach for trials involving psychedelics, Ross said.

With 300 clinical trials already designed and aspirations of formally establishing a center of experimental therapeutics at Bellevue, Ross is hoping an unconventional funding campaign slated to launch this week will generate the money he needs to take psychedelics research to the next level. Ross spoke with Crain's about the potential of psychedelics.

Do you think your research will help make psychedelics available as medicine?

I think this will create a revolution in psychiatry in terms of how care is delivered and the types of models we have. You have these taboo club drugs, if you will—ecstasy, special K, psychedelic mushrooms—that are being leveraged for very hard-to-treat disorders. Ketamine was a breakthrough in psychopharmacology for depression because it works rapidly. No other antidepressant works rapidly.

You have talked about using psilocybin to create a spiritual experience for patients. Is that difficult to do in a clinical setting?

It's such a specific treatment that I created a psychedelic psychotherapy training program. We looked at how things are done indigenously and we figured out what can be done in our sessions. We review the patients' life history and their medical history and then on dosing days we have them state their intention for the day, which is really key. We turn on preselected music, have them lie down and we're there to support them. At the end of it, they sit up and start telling us about the experiences they've had and we get them to write it down, and they come in the next day and we try to capture these very intense learning experiences.

Courtesy of NYU Langone Medical Center

Dr. Stephen Ross

Do you think psychedelics should only be used under medical supervision or should they be totally decriminalized?

When used in uncontrolled settings by the lay public I think they're harmful. I don't think they should be used in those settings. I think they should be completely medicalized. Spiritual use is also responsible. In terms of legalization, the policy of criminalizing addiction is terrible. I think that psychedelic research comes at an interesting time as drug policy is slowly shifting from these draconian measures that are not good for patients to things that are better for them.

Have you faced pushback for working with psychedelics?

Much less than I thought. I thought my bosses would kill it very quickly. Early on I thought I'd ask my boss at Bellevue and he would most definitely say no. He gave this goofy response: "I was a child of the '60s!" People asked for samples. I kept getting goofy responses from people in charge and it kind of shocked me. That said, there's been a lot of near-death experiences for this project.

Can you share a time when the project was almost killed?

Our first study on psilocybin to treat cancer-related anxiety and depression took place in a college of dentistry. Why? Because Bellevue was concerned that we were going to do weird experimentation on vulnerable minority individuals. In the arc of Tuskegee and giving black individuals syphilis, they thought, "You're going to give psychedelic drugs to dying black people—that doesn't sound right. We need to protect them." My argument was they're so special you're discriminating against them and they might benefit from some novel treatment. But I completely respected where Bellevue was coming from. Things shifted over time and now our lab is in Bellevue. So Bellevue is now proud of this research and the new phases of it will happen here.

What would you say to someone interested in getting into this area of medicine? Are there opportunities opening up?

I think this is a field that's about to explode. After The New Yorker published an article on psychedelic research in 2015, I was contacted by over two dozen major medical centers and Ivy League schools asking how they could get involved. So many students locally and throughout the country say, "This is the most exciting thing ever. I want to be a psychedelic therapist. I want to be a psychedelic researcher." I say to them, "Just keep your eyes open, wait a couple of years and this will be a field. You will be able to train as a psychedelic therapist. Psychiatry will be radically different."

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